Short-term efficacy of microwave ablation in the treatment of liver cancer and its effect on immune function

BACKGROUND Hepatectomy is the first choice for treating liver cancer.However,inflammatory factors,released in response to pain stimulation,may suppress perioperative immune function and affect the prognosis of patients undergoing hepatectomies.AIM To determine the short-term efficacy of microwave ablation in the treatment of liver cancer and its effect on immune function.METHODS Clinical data from patients with liver cancer admitted to Suzhou Ninth People’s Hospital from January 2020 to December 2023 were retrospectively analyzed.Thirty-five patients underwent laparoscopic hepatectomy for liver cancer(liver cancer resection group)and 35 patients underwent medical image-guided microwave ablation(liver cancer ablation group).The short-term efficacy,complications,liver function,and immune function indices before and after treatment were compared between the two groups.RESULTS One month after treatment,19 patients experienced complete remission(CR),8 patients experienced partial remission(PR),6 patients experienced stable disease(SD),and 2 patients experienced disease progression(PD)in the liver cancer resection group.In the liver cancer ablation group,21 patients experienced CR,9 patients experienced PR,3 patients experienced SD,and 2 patients experienced PD.No significant differences in efficacy and complications were detected between the liver cancer ablation and liver cancer resection groups(P>0.05).After treatment,total bilirubin(41.24±7.35 vs 49.18±8.64μmol/L,P<0.001),alanine aminotransferase(30.85±6.23 vs 42.32±7.56 U/L,P<0.001),CD4+(43.95±5.72 vs 35.27±5.56,P<0.001),CD8+(20.38±3.91 vs 22.75±4.62,P<0.001),and CD4+/CD8+(2.16±0.39 vs 1.55±0.32,P<0.001)were significantly different between the liver cancer ablation and liver cancer resection groups.CONCLUSION The short-term efficacy and safety of microwave ablation and laparoscopic surgery for the treatment of liver cancer are similar,but liver function recovers quickly after microwave ablation,and microwave ablation may enhance immune function.

Clinical efficacy and safety of erlotinib combined with chemotherapy in the treatment of advanced pancreatic cancer:A meta-analysis

BACKGROUND Advanced pancreatic cancer is resistant to chemotherapeutic drugs,resulting in limited treatment efficacy and poor prognosis.Combined administration of the chemotherapeutic gemcitabine and erlotinib is considered a potential first-line treatment for advanced pancreatic cancer.However,their comparative benefits and potential risks remain unclear.AIM To assess the clinical efficacy and safety of erlotinib combined with other chemotherapy regimens for the treatment of advanced pancreatic cancer.METHODS Literature on the clinical efficacy and safety of erlotinib combined with chemotherapy for advanced pancreatic cancer was retrieved through an online search.The retrieved literature was subjected to a methodological qualitative assessment and was analyzed using the RevMan 5.3 software.Ten randomized controlled trials involving 2444 patients with advanced pancreatic cancer were included in the meta-analysis.RESULTS Compared with chemotherapeutic treatment,erlotinib combined with chemotherapy significantly prolonged the progression-free survival time of pancreatic cancer patients[hazard ratio(HR)=0.78,95%CI:0.66-0.92,P=0.003].Meanwhile,the overall survival(HR=0.99,95%CI:0.72-1.37,and P=0.95)and disease control rate(OR=0.93,95%CI:0.45-0.91,P=0.84)were not significantly favorable.In terms of safety,the erlotinib and chemotherapy combination was associated with a significantly higher risk of diarrhea(OR=3.59,95%CI:1.63-7.90,P<0.05)and rash(OR=3.63,95%CI:1.64-8.01,P<0.05)compared with single-agent chemotherapy.Moreover,the risk of vomiting(OR=1.27,95%CI:0.62-2.59,P=0.51),regurgitation/anorexia(OR=1.61,95%CI:0.25-10.31,P=0.62),and infection(OR=0.72,95%CI:0.28-1.87,P=0.50)were not significant in either group.CONCLUSION Compared with a single chemotherapeutic modality,erlotinib combined with gemcitabine can prolong progression-free survival in pancreatic cancer,but does not improve survival benefit or disease control rate,and can increase the risk of diarrhea and rash.

Short-term efficacy and influencing factors of conventional chemotherapy combined with irinotecan in patients with advanced gastric cancer

BACKGROUND Gastric cancer is one of the most common cancers worldwide, with a 5-year survival rate of only 20%. The age of onset of gastric cancer is in line with the general rule of cancer. Most of them occur after middle age, mostly between 40and 60 years old, with an average age of about 50 years old, and only 5% of patients are under 30 years old. The incidence of male is higher than that of female.AIM To investigate the short-term efficacy and influencing factors of chemotherapy combined with irinotecan in patients with advanced gastric cancer.METHODS Eighty patients with advanced gastric cancer who were treated in our hospital from January 2019 to January 2022 were selected. The patients were divided into an observation group(n = 40) and control group(n = 40) by the envelope method.The control group was given preoperative routine chemotherapy. The observation group was treated with irinotecan in addition to the chemotherapy given to the control group. The short-term efficacy of treatment in the two groups, as well as tumor marker levels and quality of life before and after treatment were evaluated.RESULTS The short-term treatment effect in the observation group was better than that in the control group(P < 0.05), and the total effective rate was 57.50%. The age and proportion of tumor node metastasis(TNM) stage IV patients with ineffective chemotherapy in the observation group were(65.12 ± 5.71) years and 52.94%,respectively, which were notably higher than those of patients with effective chemotherapy(P < 0.05), while the Karnofsky Performance Scale score was(67.70± 3.83) points, which was apparently lower than that of patients with effective chemotherapy(P <0.05). After 3 mo of treatment, the SF-36 scale scores of physiological function, energy, emotional function, and mental health in the observation group were 65.12 ± 8.14, 54.76 ± 6.70, 47.58 ± 7.22,and 66.16 ± 8.11 points, respectively, which were considerably higher than those in the control group(P < 0.05). The incidence rates of grade Ⅲ-Ⅳ diarrhea and grade Ⅲ-Ⅳ thrombocytopenia in the observation group were 32.50% and 25.00%, respectively, which were markedly higher than those in the control group(P < 0.05).CONCLUSION Chemotherapy combined with irinotecan in patients with advanced gastric cancer has a good short-term efficacy and can significantly reduce serum tumor markers and improve the quality of life of patients. The efficacy may be affected by the age and TNM stage of the patients, and its long-term efficacy needs further study.

Efficacy of continuous arterial perfusion chemotherapy combined with transarterial chemoembolization regional arterial thermal perfusion in the treatment of pancreatic cancer with liver metastases

Background:The aim of the study was to investigate the efficacy of continuous transcatheter arterial infusion chemotherapy combined with transarterial chemoembolization(TACE)for the treatment of advanced pancreatic cancer with liver metastasis.Methods:Sixty patients with advanced pancreatic cancer and liver metastases were enrolled in this study.In the treatment group,31patients underwent continuous transcatheter arterial infusion chemotherapy combined with TACE regional arterial thermal perfusion,whereas 29 patients included in the control group received intravenous chemotherapy with gemcitabine and S-1.All patients received maintenance chemotherapy with S-1 after 4 cycles of the study regimen.Treatment efficacy,quality of life,survival,and toxicity were evaluated.Results:Efficacy was better in the treatment group than in the control group,as reflected by the objective remission,partial remission,and disease progression rates(all P<0.05).The Eastern Cooperative Oncology Group and Numerical Rating Scale pain scores were also higher in the treatment group(both P<0.05).In survival analysis,the 1-year overall survival rates in the treatment and control groups were64.516%and 10.345%,respectively,whereas the median overall survival times were 16 and 6 months,respectively(both P<0.05).The6-month progression-free survival rates in the treatment and control groups were 77.419%and 13.790%,respectively,and the median progression-free survival times were 12 and 3 months,respectively(both P<0.05).The rates of hematological and nonhematological toxicological adverse effects were also lower in the treatment group(both P<0.05).Although the rate of liver dysfunction was higher in the treatment group,this finding had no adverse effects on prognosis.Conclusions:Continuous transcatheter arterial infusion chemotherapy combined with TACE regional arterial perfusion chemotherapy resulted in better efficacy and safety outcomes in patients with pancreatic cancer and liver metastasis,suggesting its utility as a reference method for the clinical treatment of advanced pancreatic cancer.

Efficacy and safety of trastuzumab combined with chemotherapy for first-line treatment and beyond progression of HER2-overexpressing advanced breast cancer

Objective： To observe the efficacy and safety of trastuzumab combined with chemotherapy in patients with human epidermal growth factor receptor 2 （HER2）-overexpressing advanced breast cancer. Methods： A total of 90 patients with HER2-overexpressing advanced breast cancer were enrolled in this study. All patients were diagnosed with ductal invasive breast cancer by pathological analysis, and were aged between 31-73 years with a median of 51 years. HER2-positivity was defined as 3（＋） staining in immunochemistry or amplification of fluorescence in situ hybridization （FISH, ratio ≥2.0）. Trastuzumab was administered in combination with chemotherapy as first-line treatment and beyond progression as a second- line, third-line, and above treatment in 90, 34, 14, and 6 patients, respectively. The chemotherapy regimen was given according to normal clinical practice. The response rate was evaluated every two cycles, and the primary endpoints were progression-free survival （PFS） and overall survival （OS）. Survival curves were estimated by using Kaplan-Meier graphs and were compared by using log-rank test statistics. Multivariate analysis was done using Cox＇s proportional hazards regression model, and the level of significance was P〈0.05. Results： All 90 patients received at least one dose of trastuzumab, and efficacy could be evaluated in 85 patients. The median follow-up was 50 months. In total, 72 （80.00%） patients had visceral metastasis, and 43 （47.78%） patients had progressed after one or more extensive chemotherapy regimens for metastatic diseases. The median PFS for first-line trastuzumab was 10 months （range, 2-59 months）, and the median OS after metastasis or initially local advanced disease was 22 months （range, 2-1 16 months）. Conclusions： Trastuzumab combined with chemotherapy was active and well-tolerated as a first-line treatment and even beyond progression in HER2-overexpressing advanced breast cancer as a second-line or third-line treatment. However, its efficacy is certainly less beyond this point.

Predictive value of serum levels of transforming growth factor beta 1 for the short-term effects of radiotherapy and chemotherapy in patients with esophageal cancer

Objective To investigate variation in levels of transforming growth factor beta 1(TGF-β1)before and after radiotherapy in patients with esophageal cancer in order to evaluate the predictive value of TGF-β1 for the effects of radiotherapy Methods A total of 140 patients with esophageal squamous carcinoma undergoing radical radiation therapy in the Department of Oncology from March 2015 to December 2017 were enrolled.The patients were divided into the effective(115 cases)and ineffective(25 cases)groups according to World Health Organization(WHO)criteria for the evaluation of solid tumors(2009 RECIST standard).TGF-β1 levels were measured in all patients by using enzyme-linked immunosorbent assay(ELISA).Multiple-factor analysis of the predictive value of the treatment efficacy was performed by Cox regression analysis.Results After radiotherapy,36,79,and 25 cases experienced complete response(CR),partial response(PR),and no response(NR),respectively,with a total effective rate of 82.14%.The TGF-β1 level was significantly lower in the effective group than that in the ineffective group(P<0.05)and covariance analysis revealed significantly reduced TGF-β1 level in esophageal cancer patients following radiotherapy.The multi-factor Cox regression model revealed that the predictive value of TGF-β1 for the effect of radiotherapy was largest,with a hazard ratio[HR]of 1.955(P=0.002),followed by exposure dose,with(HR=1.367;P=0.035).Conclusion Serum TGF-β1 level can serve as a predictor for the short-term effects of radiotherapy in patients with esophageal cancer.

Efficacy and safety of chemotherapy combined with bevacizumab in Chinese patients with metastatic colorectal cancer:A prospective,multicenter,observational,non-interventional phaseⅣtrial

Objective:Bevacizumab has an important and evolving role in improving outcomes in patients with metastatic colorectal cancer(mCRC)worldwide and was approved in China in 2010.However,there are limited real-world data on the efficacy and safety of chemotherapy regimens combined with bevacizumab in Chinese patients with mCRC.This observational,phase IV trial study aimed to obtain more experience on the efficacy and safety of bevacizumab combined with chemotherapy in Chinese mCRC patients.Methods:Between September 2013 and November 2016,patients with histologically confirmed mCRC were enrolled in a prospective,multicenter,observational,non-interventional phase IV trial at 26 centers across China.Eligible patients received different chemotherapeutic regimens combined with bevacizumab.The efficacy and safety data in the intention-to-treat study population were analyzed.Results:A total of 611 patients were included in the efficacy analysis.The median overall survival and median progression-free survival was 18.00 and 10.05 months,respectively.The objective response rate was 21.00%and disease control rate was 89.40%.In subgroup analyses,the survival differences were observed according to metastatic status,duration of treatment and elevation in blood pressure.A total of 613 patients were evaluable for safety assessments.And 569(92.82%)patients reported at least one adverse event(AE),and 151(24.63%)experienced grade 3 or higher AEs.The incidence of bevacizumab-associated AEs of special interest was reported in 31(5.06%)patients with hypertension(n=12),abscesses and fistulae(n=7),bleeding(n=6),proteinuria(n=3),gastrointestinal perforation(n=2)and venous thrombotic events(n=1).Conclusions:This observational phase IV trial broadens our experience and knowledge of bevacizumab in the Chinese population and provides a good indication of its overall efficacy and safety.Bevacizumab in combination with chemotherapy offers clinical benefits to Chinese patients with mCRC and has an acceptable and manageable safety profile.

A PRELIMINARY STUDY OF SHORT-TERM EFFICACY OF Nd:YAG LASER PERIPHERAL IRIDOTOMY IN PATIENTS WITH PRIMARY ANGLE CLOSED GLAUCOMA

Q-switched Nd:YAG laser was used for the peripheral iridotomy in 68 cases(80 eyes) of primary angle closed glaucoma. The average number of laser shots is 20.5(1～127 shots), and the average shot energy is 2.5 mJ(0.9～5.6mJ). The successful rate of iris penetration is about 97.6%. The size of the iris hole is not smaller than 0.2mm^2. The kind of the iris is the most important factor that causes the marked variation in laser shots and in laser shot energy. The main complications of Nd:YAG laser iridotomy p...

Tumor-feeding artery diameter reduction is associated with improved short-term effect of hepatic arterial infusion chemotherapy plus lenvatinib treatment

BACKGROUND Recently,hepatic arterial infusion chemotherapy(HAIC)plus lenvatinib has been frequently used to treat unresectable hepatocellular carcinoma(uHCC)in China.In the clinic,the hepatic arteries of some patients shrink significantly during this treatment,leading to improved short-term efficacy.AIM To investigate the relationship between the shrinkage of hepatic arteries and the short-term effect of HAIC plus lenvatinib treatment.METHODS Sixty-seven participants with uHCC were enrolled in this retrospective study.The patients received HAIC every 3 wk,followed by oral lenvatinib after the first HAIC course.Hepatic artery diameters were measured on CT before treatment and after 1 and 2 mo of treatment.Meanwhile,the changes in tumor capillaries were also examined on pathological specimens before and after 1 mo of treatment.The antitumor response after 1,3,and 6 mo of treatment was assessed using the modified Response Evaluation Criteria in Solid Tumors(mRECIST).The relationship between the changes in vessel diameters and the short-term effect of the combination treatment was evaluated by receiver-operating characteristic and logistic regression analyses.RESULTS The hepatic artery diameters were all significantly decreased after 1 and 2 mo of treatment(P<0.001),but there was no difference in the vessel diameters between 1 and 2 mo(P>0.05).The microvessel density in the tumor lesions decreased significantly after 1 mo of combination treatment(P<0.001).According to mRECIST,46,41,and 24 patients had complete or partial responses after 1,3,and 6 mo of treatment,respectively,whereas 21,21,and 32 patients had a stable or progressive disease at these times,respectively.Shrinkage of the tumor-feeding artery was significantly associated with the tumor response after 1,3,and 6 mo of treatment(P<0.001,P=0.004,and P=0.023,respectively);however,changes in other hepatic arteries were not significantly associated with the tumor response.Furthermore,shrinkage of the tumor-feeding artery was an independent factor for treatment efficacy(P=0.001,P=0.001,and P=0.002 and 1,3,and 6 mo,respectively).CONCLUSION The hepatic arteries shrank rapidly after treatment with HAIC plus lenvatinib,and shrinkage of the tumor-feeding artery diameter was closely related to improved short-term efficacy.

Concurrent chemotherapy and reduced - dose cranial spinal irradiation followed by conformal posterior fossa tumor bed boost for average - risk medulloblastoma: efficacy and patterns of failure

PURPOSE:To review the efficacy and patterns of failure in average-risk medulloblastoma patients treated withconcurrent chemotherapy and reduced-dose cranial spinal irradiation and a conformal tumor bed boost.METH-ODS AND MATERIALS:Thirty-three patients with average risk(defined as<==1.5 cm(2)of residual tumorafter resection,age>3 years,and no involvement of the cerebrospinal fluid or spine)medulloblastoma werediagnosed at our institution between January 1994 and December 2001.They were enrolled in an institutional

Evaluation of the Effect of Shenmai Injection on Chemotherapy Efficacy and Side Effects of Acute Leukemia

Objective.To study the effect of Shenmai injection on the efficacy and side effects of chemotherapy in acute leukemia.Methods.Sixty-two patients with acute leukemia admitted to the hospital between February 2018 and June 2019 were enrolled in this study.All patients were divided into observation and control groups according to different treatment methods in chemotherapy.The control group was treated with chemotherapy alone.The observation group was treated Shenmai injection combined with chemotherapy.The treatment effect of the two groups was compared,and the incidence of bone marrow blood and side effects before and after treatment were compared.Results.The therapeutic effect of the observation group was 93.55%which was much higher than that of the control group of 74.19%,P<0.05.The bone marrow blood levels of WBC,PLT and Hb in the observation group before and after treatment were 23.97±3.05,6.76±1.27,69.01±8.15,66.96±9.46,91.07±8.15,89.35±7.46,respectively,compared with the control group.The difference in the situation after treatment was found to be significant.The incidence of toxic side effects such as nausea and vomiting,impaired liver function and renal dysfunction in the observation group was 9.68%,which was lower than that of the control group(32.26%,P<0.05).Conclusion.Shemai injection has significant effects on the efficacy and side effects of chemotherapy in acute leukemia and effectively improves the effect of chemotherapy.

Clinical efficacy of oral enteral nutrition in lung cancer patients receiving chemotherapy and/or radiotherapy： a systematic review of randomized controlled trials

目的：系统评价口服肠内营养支持对接受放化疗的肺癌患者的临床疗效与可行性.方法：计算机检索相关主要中英文数据库,并手工检索相关营养学杂志.采用The Cochrane Colla boration’stool for assessingrisk of bias5.1.0进行质量评价,RevMan5.1软件进行统计分析.由于纳入的研究之间有明显的临床异质性和其他潜在的差异,不适合行meta分析,因此行简要定性分析更加合适.结果：最终纳入5个随机对照试验（RCT）,其中3个RCT研究对象接受化疗,1个RCT研究对象接受放疗,1个RCT研究对象接受放疗及化疗.综合的分析结果提示口服肠内营养仅能够显著提高接受化疗肺癌患者的能量和蛋白质摄入量,然而对于体重、营养状态、生存质量、治疗反应或者生存时间没有显著影响.结论：现有的证据不足以证明常规口服肠内营养支持能使接受放化疗的肺癌患者获益,由于样本量少,各研究之间差异大,更多高质量的随机对照试验有待进行.

Analysis of the Short-Term Curative Effect of Roxadustat in Treating Renal Anemia in Patients with Peritoneal Dialysis

Objective:To analyze the short-term curative effect of roxadustat in the treatment of renal anemia in patients with peritoneal dialysis.Methods:70 patients with peritoneal dialysis renal anemia admitted to the dialysis department of our hospital from March 2021-March 2023 were selected as research objects,divided into a research group and a reference group according to random number drawing method,with each group consisting of 35 cases.The patients in the research group were treated with roxadustat,and those in the reference group were treated with recombinant human erythropoietin.The total efficacy,anemia index,iron metabolism index,and occurrence of adverse reactions were compared between the two groups.Results:The total efficacy of the treatment received in the research group was significantly higher than that in the reference group(P<0.05).In terms of anemia indicators,there was no statistically significant difference between the hemoglobin(Hb),the red blood cell(RBC),and the hematocrit(HCT)of both groups(P>0.05)before treatment.After treatment,the anemia indicators of the patients in the research group were significantly better than those in the reference group,(P<0.05).In terms of iron metabolism,before treatment,there was no significant difference between the total iron-binding capacity(TIBC),the transferrin(TRF),the ferritin(FER),and iron(Fe)of both groups(P>0.05).After treatment,the research group’s iron metabolism indicators were significantly better than those of the reference group(P<0.05).The incidence of adverse reactions in the research group was significantly lower than that in the reference group(P<0.05).Conclusion:The short-term curative effect of roxadustat in the treatment of peritoneal dialysis patients was demonstrated through this study,making it a viable treatment option.

益生菌辅助化疗对晚期大肠癌患者的临床疗效和安全性评价

目的 探讨益生菌辅助化疗对晚期大肠癌(CRC)患者临床疗效和安全性的影响。方法 选取2022年3月至2023年3月湖南师范大学第一附属医院收治的晚期CRC患者为研究对象。采用随机数字表法将CRC患者随机分为试验组(双岐杆菌三联活菌胶囊、卡培他滨+奥沙利铂)和对照组(卡培他滨+奥沙利铂)。比较两组治疗后近期疗效(客观缓解率和疾病控制率)、胃肠道不良反应发生率、Karnofsky功能状态(KPS)评分及血清肿瘤标志物糖类抗原72-4(CA72-4)、糖类抗原19-9(CA19-9)和癌胚抗原(CEA)的水平。结果 共纳入120例CRC患者,试验组和对照组各60例。与对照组相比,试验组客观缓解率、疾病控制率显著提高(P <0.05)。胃肠道不良反应方面,两组患者恶心、反酸发生率差异无统计学意义(P> 0.05);试验组腹痛、腹胀、便秘和腹泻发生率明显低于对照组(P <0.05)。治疗前,两组KPS评分、血清CA72-4、血清CA19-9和血清CEA水平差异无统计学意义(P> 0.05);治疗4周期后,试验组KPS评分明显高于对照组(P <0.05),血清CA72-4、血清CA19-9和血清CEA水平低于对照组(P <0.05)。结论 益生菌辅助卡培他滨+奥沙利铂治疗可提高晚期CRC患者近期疗效,减轻胃肠道不良反应,改善生存质量。

维奈克拉联合阿扎胞苷与“7+3”方案在新诊断老年急性髓系白血病中近期疗效的初步观察

目的:比较维奈克拉(VEN)联合阿扎胞苷(AZA)与标准“7+3”方案诱导治疗新诊断老年急性髓系白血病(AML)的近期疗效及不良反应。方法:回顾性分析山西医科大学第二医院和山西白求恩医院自2021年1月至2022年1月间接受VEN+AZA方案(41例)或“7+3”方案(38例)诱导治疗且资料完整的79例老年AML患者的临床数据,采用倾向性评分匹配法(PSM)均衡组间混杂因素后,比较组间缓解率、总生存时间(OS)、无进展生存时间(PFS)以及不良反应。结果:VEN+AZA组总反应率(ORR)为68%,“7+3”组为84%,其中复合缓解率(CR+CRi;CRc)分别为64%和72%,两组ORR(P=0.185)及CRc(P=0.544)均无统计学差异。VEN+AZA组的5例未缓解(NR)患者中,4例伴7号染色体异常(7q-/-7),1例伴ETV6基因突变。两组中位随访时间分别为8和12个月,6个月OS、PFS率均无统计学差异(84%vs 92%,P=0.389;84%vs 92%,P=0.258)。两组的血液学不良反应主要是Ⅲ-Ⅳ级骨髓抑制,其发生率比较无统计学意义(P>0.05)。两组中性粒细胞恢复中位时间分别为27(11-70)和25(14-61)d(P=0.161),血小板恢复中位时间分别为27(11-75)和25(16-50)d(P=0.270),差异无统计学意义。VEN+AZA组感染发生率低于“7+3”方案组(56%vs 88%,P=0.012),两组肺部感染率分别为36%和64%(P=0.048),差异均有统计学意义。结论:VEN+AZA和标准“7+3”方案治疗新诊断老年AML的近期疗效相近,但VEN+AZA组感染发生率低。伴有7号染色体异常(7q-/-7)可能是老年AML患者接受VEN+AZA治疗的不良预后因素。

信迪利单抗联合常规化疗在复发转移宫颈癌治疗中疗效和安全性研究

目的探究程序性死亡受体1(PD-1)抑制剂信迪利单抗(达伯舒)联合常规化疗在复发转移宫颈癌治疗中短期疗效、长期疗效和安全性。方法筛选2019年3月至2020年8月河北北方学院附属第一医院符合纳入、排除标准的复发转移宫颈癌病人88例,采用中央随机系统分配法分为试验组(n=44)和对照组(n=44)。对照组执行常规化疗方案,试验组执行信迪利单抗联合常规化疗方案。参考实体肿瘤疗效评估标准(RECIST)1.1来评价并比较两组病人短期疗效。通过随访和记录无进展生存期(PFS)来评价并比较两组病人长期疗效。参考常见不良事件评价标准(CTCAE)5.0版来评价两组病人不良事件和安全性。结果短期疗效:试验组客观缓解率为47.73%,显著高于对照组18.18%(P=0.035);试验组持久临床受益率为86.36%,显著高于对照组的43.18%(P=0.048)。长期疗效:试验组中位PFS为7.22个月[95%CI:(4.38,14.04)],显著长于对照组的4.31个月[95%CI:(3.43,9.25)](P=0.032)。试验组中位总生存期(OS)为17.30个月[95%CI:(14.33,17.58)],死亡风险显著低于对照组的6.93个月[95%CI:(4.89,13.25)](P=0.039)。Cox回归分析结果显示肿瘤突变负荷(P=0.036)、化疗疗程(P=0.022)、组织学类型(P=0.018)和转移灶位点(P=0.035)是试验组治疗效果的独立预后因素。结论信迪利单抗联合常规化疗方案显著提高了复发转移宫颈癌病人的短、长期疗效,不良反应未明显增加,具有一定临床价值。

艾迪注射液联合常规化疗对肺癌脑转移患者的临床疗效

目的观察艾迪注射液联合化疗对肺癌脑转移患者认知障碍的缓解情况。方法回顾性分析2018年6月至2020年6月在浙江省丽水市人民医院就诊的80例肺癌脑转移患者的临床资料,按照不同治疗方法分为常规化疗组和艾迪组,常规化疗组患者采用顺铂联合多西他赛的化疗方案,艾迪组在常规化疗组基础上予以艾迪注射液。观察2组患者的近期疗效、认知功能以及毒副作用,评价联合艾迪注射液治疗的有效性和安全性。结果常规化疗组患者近期有效率50%,艾迪组患者近期有效率73%,2组差异有统计学意义(χ^(2)=4.266,P=0.039)。治疗开始前,常规化疗组和艾迪组患者的蒙特利尔认知评估量表(MoCA)评分和简易智能量表(MMSE)评分差异无统计学意义。治疗后2周,与常规化疗组比较,艾迪组患者的MoCA评分和MMSE评分均增加,差异具有统计学意义(t=-3.462、-2.507,P=0.001、0.047);治疗后2周艾迪组患者的Karnofsky评分和生活质量量表(QOL)评分升高,差异具有统计学意义(t=-4.634、-4.050,P<0.01)。与常规化疗组比较,艾迪组患者骨髓抑制和眩晕情况减轻,差异具有统计学意义(χ^(2)=4.126、4.050,P=0.042、0.044),恶心呕吐等胃肠道反应和脱发情况差异无统计学意义(P>0.05)。80例患者均因本病死亡。常规化疗组患者平均生存期为(15±3)个月,艾迪组患者的中位生存期为(18±4)个月,2组差异无统计学意义(χ^(2)=17.752,P<0.01)。结论艾迪注射液联合常规化疗方案治疗肺癌脑转移患者可提升近期疗效,缓解认知障碍,减轻化疗的毒副作用,但对于患者的生存期无明显影响。

维奈克拉联合阿扎胞苷治疗成人不适合强化疗急性髓系白血病的疗效及安全性分析

目的:观察维奈克拉(VEN)联合阿扎胞苷(AZA)治疗成人不适合强化疗急性髓系白血病(unfit AML)的临床疗效及安全性。方法:收集2021年1月至2022年5月山西医科大学第二医院收治的21例接受VEN联合AZA治疗的成人unfit AML患者的临床资料,回顾性分析该联合方案的疗效及安全性。结果:21例unfit AML患者接受VEN联合AZA治疗1个疗程后,16例达完全缓解(CR)/完全缓解伴血液学不完全恢复(CRi),2例达部分缓解(PR),总反应率(ORR)为85.7%。16例达CR/CRi的患者中13例微小残留病(MRD)转阴。11例预后不良患者中,8例达CR/CRi。至随访截止日期,21例患者的中位总生存(OS)期未达到,1年的OS率为61.7%。VEN联合AZA的主要不良反应为骨髓抑制、胃肠道反应和感染。发生3-4级白细胞减少13例、中性粒细胞减少7例、贫血7例、血小板减少4例。发生胃肠道反应和感染的患者分别为11例和7例。以上不良反应均可控且可耐受。无肿瘤溶解综合征发生,未发生感染相关死亡。结论:VEN联合AZA方案可使成人unfit AML患者快速获得深度缓解,安全性良好。

局限期小细胞肺癌化疗疗效及临床预后因素分析

目的研究局限期小细胞肺癌患者化疗治疗的效果及临床预后的相关因素。方法选取90例局限期小细胞肺癌患者作为观察对象。所有患者均接受化学药物治疗,统计临床疗效、生存时间以及治疗后18个月的生存率。对患者的病历资料展开回顾性分析,总结影响临床预后的相关因素。结果治疗临床总有效率为65.56%,患者于治疗过程中骨髓抑制发生率、胃肠道反应发生率分别为24.44%、57.78%。随访结束,6个月生存率为66.67%,12个月生存率为33.33%,18个月生存率为17.78%。单因素分析发现,临床预后与患者年龄、功能状态(PS)评分、吸烟习惯、体重下降幅度、治疗前血小板计数有关(P<0.05),多元回归分析发现,吸烟、PS评分为影响患者预后的主要因素。结论局限期小细胞肺癌患者接受化学药物治疗可获得理想的临床疗效,而患者的临床预后与体重、吸烟、PS评分以及治疗前血小板计数等因素有密切关联。

多学科协作护理专案在日间结直肠癌患者院外口服化疗药中的应用

目的探讨结直肠癌患者接受护理专案干预后对提高口服化疗药服药依从性、强化自我效能的作用。方法选择2022年6月至2022年12月在我院接受药物化疗治疗的结直肠癌患者300例作为研究对象,按照计算机随机编号抽取结果进行分组,对照组(150例)患者实施常规模式护理;观察组(150例)患者开展护理专案模式护理,对两组患者护理前后口服化疗药物服药依从性予以评估,比较两组结果的统计学差异。另外分别评估两组患者护理前后自我效能及生活质量,分析评分变化趋势。结果两组患者实施护理前服药依从性各个方面评分组间对比无统计学差异(P>0.05),观察组患者通过护理专案干预后,服药依从性评分高于对照组(P<0.05)。另外,观察组患者自我效能评分、生活质量评分均高于对照组(P<0.05)。结论针对结直肠癌患者通过实施护理专案干预能够有效提高口服用药的依从性,强化患者自我管理效能,提高生活质量,值得运用推广。